Effect of antenatal education and midwifery-led care on maternal anxiety, depression, and birth outcomes: A meta-analysis of clinical trials

作者：Yang Xu, Yingying Han, Wang Li, Hui Xue, Yue Liu, Y. Men, Yinxin Chen, Xiaoyun Zhou, Qianqian Li · 发表于：Women and Birth · 年份：2025 · DOI：10.1016/j.wombi.2025.102138 · 被引用次数：6 · 研究领域：Maternal and Perinatal Health Interventions、Maternal Mental Health During Pregnancy and Postpartum、Breastfeeding Practices and Influences

BACKGROUND: Psychological distress during pregnancy-including anxiety, depression, and fear of childbirth can adversely affect maternal well-being and obstetric outcomes. Midwifery-led care, which integrates antenatal education and psychosocial support, has been increasingly recognized as an effective approach to enhance maternal mental health and birth experiences. However, evidence from clinical trials remains fragmented and inconsistent. METHODS: A systematic review and meta-analysis were conducted following the PRISMA 2020 and Cochrane guidelines. Randomized controlled trials (RCTs) assessing the effects of midwifery-led interventions, including psychoeducation, counselling, mindfulness, continuity of care, and group prenatal care-on maternal psychological and obstetric outcomes were identified through PubMed, Embase, CENTRAL, Web of Science, and CINAHL up to January 2024. Pooled effect sizes were calculated via random-effects models (REMLs) with standardized mean differences (SMDs) or risk ratios (RRs) and 95 % confidence intervals (CIs). RESULTS: A total of 18 RCTs involving 7462 women were included. Compared with standard or routine care, midwifery-led interventions significantly reduced maternal anxiety (SMD = -0.51, 95 % CI -0.62 to -0.39), depression (SMD = -0.61, 95 % CI -0.77 to -0.45), and fear of childbirth (SMD = -0.77, 95 % CI -1.06 to -0.49) while enhancing maternal satisfaction and self-efficacy (SMD = 0.46, 95 % CI 0.36-0.57). Regarding obstetric outcomes, ...